Emily Beswick reviews 'How the Brain Lost Its Mind', which challenges our misunderstanding of brain disease and mental illness. Explore the overlooked history of neurosyphilis, "the Great Imitator", which swept through European society in the nineteenth century, affecting many famous names including Vincent van Gogh and Al Capone.
What does it mean to be ‘mad’? In ‘How the Brain Lost its Mind’, the authors delve into the history of madness and how its definition has been constructed by society. They provide stories of the first neurologists, psychiatrists and alienists who attempted to find the causes and cures for madness. Through an exploration into neurosyphilis, this book encourages readers to consider how a disease of the brain affects a person’s mind and sanity.
The co-authors, Dr Allan H. Ropper, Professor of Neurology at Harvard University, and Brian David Burrell, mathematician at the University of Massachusetts Amhurst, bring contrasting and unique viewpoints to the narrative. Ropper and Burrell have previously co-authored ‘Reaching Down the Rabbit Hole’ together, an exciting collection of unusual cases from the neurology clinic, exploring what different symptoms can teach us about the journey towards a medical diagnosis.
Ropper and Burrell present a brief history, explanation, and exploration of neurosyphilis. They examine the mysterious cases of historical figures who were, likely, affected by the condition and the stories of doctors who sought to better understand these, often odd, presentations. Syphilis, itself, was known as ‘The Great Imitator’ because its myriad of symptoms could easily impersonate those of other conditions. This book primarily focuses
on neurosyphilis, a manifestation of the disease that attacks the central nervous system, potentially damaging the frontal and temporal lobes of the brain. This results in the symptoms of psychosis, that have often been misdiagnosed as hysteria, or mislabelled as madness. I particularly enjoyed how the authors brought these patients to life, giving them stories and personalities, based on information from case notes and clinical records. I found myself engaged in the patients’ lives and what their delusions can tell us about them, often hoping for a resolution of their symptoms.
Of course, Jean-Martin Charcot, the ‘father’ of clinical neurology, makes an appearance. We are transported off to late 1800’s Paris, where the authors reimagine the scenes of Charcot bringing his ‘star’ patients, from the University Hospital, onstage to demonstrate hysteria and hypnosis. The added historical context from Ropper and Burrell, throughout the book, explores how these conditions were understood and viewed, as neurology and psychiatry emerged in medicine. Ropper and Burrell’s insights into the lives and attitudes of key historical figures provides an entertaining narrative of medicine in the 19th century.
As syphilis is a bacterial infection that was primarily, but not exclusively, transmitted through sexual contact, a significant amount of social stigma was attached to it. This shame, the lack of treatment options, and the fact that syphilis can also lay dormant in the body for decades without symptoms, meant many people did not seek medical intervention. The patients in this book represent the more extreme behavioural presentations because their neurosyphilis was advanced - they likely died soon after they were provided with medical care. The authors present the patient’s cases respectfully, whilst ensuring that the reader remains entertained and engaged.
"What we tend to forget is that the brain is just a platform for the mind, not its blueprint"
Ropper & Burrell also explore some important ongoing discussions about the differing ways that mental illness, with a known biological cause (in this case syphilis), is managed in medicine and viewed by society. In illnesses where the biological cause is not known, or is less well understood - represented in this book by the authors’ comparison to hysteria - there can be a tendency to minimise the psychological and social determinants of disease.
The authors end with a reminder that is particularly pertinent in neuroscience: “What we tend to forget is that the brain is just a platform for the mind, not its blueprint” (Ropper & Burrell). This book is an enjoyable and informative insight into clinical neurology throughout history. The authors provide a balance of cases, biographies and stories that make for an engaging read whilst urging you to reflect on how we continually redefine ‘madness’ as a society.
This article was written by Emily Beswick and edited by Rebecca Pope. Interested in writing for WiNUK yourself? Contact us through the blog page and the editors will be in touch!